MEDICARE: DR. DENNIS JORGE ALBINO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	12281	PR
2	207V00000X	Obstetrics & Gynecology Physician	2014010396	MO

General Provider Information

NPI Number	:	1336119304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS JORGE ALBINO M.D.

Provider Business Mailing Address
First Line	:	1100 N KENTUCKY AVE
Second Line	:	P.O. BOX 1100
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-2029
Country	:	US
Telephone Number	:	417-257-6782
Fax Number	:

Provider Business Practice Location Address
First Line	:	1627 GIBSON ST
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-1873
Country	:	US
Telephone Number	:	417-256-1838
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	02/13/2024

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